Diverticulosis of the appendix

Trollope, Michael L.; Lindenauer, S. Martin

doi:10.1007/bf02588104

Cited by 69 publications

(47 citation statements)

References 46 publications

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“…Diverticula of the appendix are uncommon, reportedly present in 0.004 to 2% of appendectomies (1)(2)(3). The incidence of these lesions may be underreported because of their small size (often Ͻ.5 cm), causing them to be overlooked at gross examination.…”

mentioning

confidence: 99%

“…Acquired appendiceal diverticula are approximately 10 times more common than the congenital type (3,4), and the pathogenesis of these acquired lesions is controversial. Theories historically have included a postinflammatory reaction, weakness in the appendiceal wall as a result of the vascular hiatus, and lumenal obstruction (2). Acquired diverticula have been associated with numerous conditions, including appendiceal adenocarcinoma and benign neural lesions (2,5,6); there is also an association with cystic fibrosis (7).…”

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confidence: 99%

“…In one large study, approximately 34% of appendiceal cystadenomas were associated with diverticula (13), but to our knowledge, this association and its implications have not been subsequently examined. There have also been rare reports of pseudomyxoma peritonei associated with appendiceal diverticula alone (2,5,14,15). As the possible associations among diverticula, low-grade appendiceal mucinous tumors, and pseudomyxoma peritonei have not been well characterized, our goal was to explore associations among these lesions and to examine the possible role of appendiceal diverticula in the pathogenesis of pseudomyxoma peritonei.…”

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confidence: 99%

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The Coexistence of Low-Grade Mucinous Neoplasms of the Appendix and Appendiceal Diverticula: A Possible Role in the Pathogenesis of Pseudomyxoma Peritonei

et al. 2000

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We examined 38 appendectomies with diagnoses of mucocele, diverticulum, or adenoma to study the coincidence of appendiceal diverticula and appendiceal low-grade mucinous neoplasms and to examine the possible role of diverticula in the pathogenesis of pseudomyxoma peritonei. Invasive adenocarcinomas and retention cysts were excluded (six cases). Cases were classified as adenomas or mucinous tumors of unknown malignant potential, with or without diverticula. Medical records were reviewed for multiple parameters, including presenting symptoms, presence of pseudomyxoma peritonei, and presence of associated malignancies. Binomial statistics were used to calculate the probability that the observed prevalence of low-grade mucinous neoplasms and diverticula together was significantly different from the expected prevalence of diverticula or low-grade mucinous neoplasms alone, using historical controls from the literature.Twenty-five percent of the total cases (8 of 32) contained both a low-grade mucinous neoplasm (7 cystadenomas and 1 mucinous tumor of unknown malignant potential) and a diverticulum. Thus, 8 of 19 low-grade mucinous neoplasms (42%) were associated with diverticula. Of the appendices with both low-grade mucinous neoplasms and diverticula, three contained dissecting acellular mucin within the appendiceal wall, four showed diverticular perforation, and one had pseudomyxoma peritonei associated with the ruptured diverticulum.A significant percentage (P < .001) of cases contained low-grade mucinous neoplasms and diverticula together. The case of coexistent low-grade mucinous neoplasm, diverticulum, and pseudomyxoma peritonei suggests that diverticula could play a role in the pathogenesis of pseudomyxoma peritonei. This could occur either by involvement of preexisting diverticula by the neoplasm or by distention of the appendiceal lumen by mucin, leading to increased intraluminal pressure and subsequent diverticulum formation at a weak area in the wall. Either mechanism might allow low-grade mucinous neoplasms to penetrate the appendiceal wall more easily. KEY WORDS

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confidence: 99%

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confidence: 99%

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confidence: 99%

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The Coexistence of Low-Grade Mucinous Neoplasms of the Appendix and Appendiceal Diverticula: A Possible Role in the Pathogenesis of Pseudomyxoma Peritonei

et al. 2000

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“…The etiology of acquired diverticula is controversial, although postinflammation and luminal obstruction appear to be the most probable mechanisms. 6 In our case, no history of inflammation was documented and no appendicoliths were found on pathologic examination.…”

Section: Discussionmentioning

confidence: 84%

Sonographic appearance of an appendiceal diverticulum

Konen

Edelstein

Osadchi

et al. 2001

J of Clinical Ultrasound

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The increasing use of sonography for evaluating acute abdomen has brought greater recognition of appendicular abnormalities. We present an incidental finding of an appendiceal diverticulum during a sonographic examination of a 4-year-old child with acute appendicitis. Abdominal sonography showed an enlarged, swollen appendix with a diameter of 1.1 cm and a small, fingerlike lateral projection approximately 2.0 cm from its tip. The specimen, resected during an appendectomy, was 5.5 cm long and 1.0 cm in diameter and had a 0.3-cm outpouching. Microscopic examination revealed a pseudodiverticulum composed of mucosa and muscularis mucosa.

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“…1 It classically has two variants: congenital and acquired. 2 Congenital diverticula are real diverticula including mucosa, submucosa, serosa, and, most importantly, the muscular layers. Acquired diverticula are false structures which do not have a muscular layer.…”

Section: Discussionmentioning

confidence: 99%